C-Brace® Leg Orthosis: Therapy exercises 10/16 – Training on the stepper │ Ottobock

C-Brace® Leg Orthosis: Therapy exercises 10/16 – Training on the stepper │ Ottobock


C-Brace
Training on the stepper The hydraulics of the C-Brace permit controlled flexion of the orthotic joint under load while descending stairs. Start training on the stepper. In the course of this training, it may become evident that the stance flexion resistance needs to be adjusted. Basic exercises When training on the stepper, the patient gets off the stepper with the non-orthosis leg and permits the knee of the orthosis leg to flex.. Putting a load on the orthosis leg under flexion is difficult for many patients because of their previous orthosis. Descending stairs requires a great deal of practice in this case in order to develop confidence. The therapist can support foot placement and guide the knee during the movement at first. The middle of the foot should be positioned on the edge of the step to ensure a smooth rollover while descending. A strip of tape on the shoe serves as a guide. A strip of tape on the floor likewise supports an appropriate stride length. During the movement sequence, ensure that the patient steps down vertically and does not let themselves “fall” forward in the direction of movement. Also check the leg axis: the foot, knee and hip must remain in a line. Common mistakes Make sure the following mistakes are avoided: If the foot is positioned too far forward, there is a risk of slipping off the step under load. Practise correct foot positioning in this case. The stance release may occur unintentionally if the patient does not permit knee flexion. This is very dangerous on stairs and definitely must be avoided. The same risk arises if the foot is positioned too far back or if the patient lets themselves fall forward. Correct adjustment of the stance flexion resistance is important so the exercise can be completed properly. If the patient feels they aren’t receiving sufficient support while descending, or if the patient finds it difficult to flex the orthotic joint, the stance flexion resistance should be checked and adjusted as needed. An inhibited motion sequence or pronounced exterior rotation of the orthosis leg indicates that the stance flexion resistance is set too high. If the orthotic joint yields very quickly, the patient feels unsafe or holds on to the handrail tightly, this indicates that the resistance is set too low. In order to find a good setting for everyday use, the stance flexion resistance should be checked regularly, especially at the start of therapy, and adjusted when needed. As soon as the patient can perform this exercise confidently on the stepper, training on the stairs can begin. C-Brace
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